CAUTION- All evidence hierarchies are an oversimplification. Big data clinical studies/analysis, qualitative research, action research, etc. are often ignored or under-appreciated. Pyramids like this one are useful visual tools, but be aware there is nuance they cannot capture.
Evidence provided by research is often discussed as a hierarchy. The most robust evidence, systematic reviews, are at the very top of the evidence pyramid, because they are the most intensively reviewed.
Filtered Information
Unfiltered Information
For more info, check out this Quantitative Study Designs guide from Deakins University in Australia. They also offer information about Qualitative Study Design, and a video which is useful to understanding Qualitative vs. Quantitative Study Design.
Authors of a systematic review;
A systematic review with meta-analysis combines all the results of all the studies into a single statistical analysis of results.
Evidence summaries & evidence guidelines
Sometimes you need to search the primary literature. Read below to determine the best evidence you are likely to find based on the domain of the study or research, In PubMed MEDLINE and CINAHL you can use limiters to search for only Clinical Trials.
"Evidence-based nursing (EBN) means using the best available evidence from research, along with patient preferences and clinical experience, when making nursing decisions."
Cullum N. (2000) Users' guides to the nursing literature: an introduction. Evidence Based Nursing. Jul;3(3):71-2. doi:10.1136/ebn.3.3.71
"An ongoing process by which evidence, nursing theory and the practitioners’ clinical expertise are critically evaluated and considered, in conjunction with patient involvement, to provide delivery of optimum nursing care for the individual."
Scott, K. & McSherry, R. "Evidence Based Nursing: clarifying the concepts for nurses in practice." Journal of Clinical Nursing 2009; 18(8): 1085-95.
Steps in Evidence Based Practice are:
"Both evidence-based medicine and evidence-based nursing are forms of evidence-based practice. However, nursing’s approach to evidence-based practice may differ from the biomedical model. Nurses provide holistic care, treating and working with patients rather than working on them. When nurses make clinical decisions about therapeutic interventions, they frequently consider not only effectiveness of treatment, but also cost-effectiveness and acceptability to the patient."
McSherry, R., Simmons, M., & Abbott, P. (Eds.). (2002). Evidence-informed nursing: A guide for clinical nurses. New York: Routledge.
Different types of research studies are better suited to answering questions in various domains of inquiry. ALL research questions are best answered by well-done Meta-Analysis or Systematic Reviews; however, sometimes they are not available. In those cases, here are suggestions for types of single study by domain.
Domain— Single Study Types
Therapy— Randomized Controlled Trials (RCTs)
Prevention— Randomized Controlled Trials (RCTs) > cohort > case control > case series
Etiology/Harm— Cohort > case control > case series
Prognosis— Cohort (follow-up) > case control > case series
Diagnostic— Prospective, blind comparison to gold standard